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Orit Cohen Castel, Khaled Karkabi, Lital Keinan-Boker, Uzi Milman, Orna Geyer; Medication Adherence Of Glaucoma Patients In The Primary Care Setting In Israel. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5070.
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To understand the factors that influence glaucoma treatment adherence.
A retrospective cohort study was conducted using database of the healthcare plan in the north of Israel (Clalit Health Services, Haifa & Western Galilee) between January 1 and December 31, 2007. From 10,000 persons who were prescribed glaucoma medications, a sample of 741 patients was selected for detailed abstraction. Adherent and nonadherent individuals were classified as such based on number of prescription claims for any ocular hypotensive medication during the study period. Demographics, response to telephone interview questions about glaucoma knowledge, drop-taking behavior, experiences with medication, communication with the physician and health-related beliefs associated with adherence behavior were obtained from each patient.
Among 741 participants, 481(65%) were poor adherers (1-5 prescription claims/ year) and 260 (35%) were good adherers (11-12 prescription claims/year). Seven variables that affect adherence to glaucoma medication regimens were identified. Older age (OR=0.96, 95% CI 0.94-0.98), frequent dosing regimens (OR=0.77, 95% CI 0.70-0.85) and good communication with the ophthalmologist (OR=0.44, 95% CI 0.25-0.75) were promoters. In contrast, male gender (OR=1.55; 95% CI 1.1-2.19), lower income (OR=2.73, 95% CI 1.59-4.67), lack of knowledge of the benefits in taking the medication regularly (OR=1.42, 95% CI 1.19-1.68) and the request for help during application of eyedrops (OR=2.15, 95% CI 1.42-3.26) were barriers to adherence.
Strategies aimed at improving adherence in glaucoma patients need to address medication regimen, optimizing patient education about the benefits in taking the medication regularly, doctor-patient communication and problem-solving regarding help during application of eyedrops.
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